HomeMy WebLinkAbout4309 FALMOUTH ROAD - Wood Stove Permit 01/20/80 Hof a�
TOWN OF BARNSTABLE
i HARTSTAX
0J9 MASSACHUSE YrS.
Wood Stove Permit
DATE OF APPLICATION ............ ..`.c ± ... ' . `..��...................... FIRE DEPT. ISSUING PERMIT ..........................................................
NAME (owner) .......I................... NAME (Installer) ........................:.............................................. �
ADDRESS �n.9... �..:. LTV i ADDRESS
STOVE &J-29S.5 60�) CHIMNEY: NEW ........................ EXISTING ..............
r
Manufacturer ,,s,,,S.� CHIMNEY: Masonry ........`..:� ...................................................................
.....................................................................
Mass. Approval .......1Y.:�..z .................... CHIMNEY: Metal ...................................:............................................................
�.
This is to certify that the above installer has permission to install a wood burning appliance at the listed address
in accordance with an application on file with the ....................................................... !.. ..t...%.......................... Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations 'made
under the authority thereof.
IssuedBy: ,. �' ........... r ..... �;Gr .�1,;•f• ,.:. ................Title .! .1 tV ................. ......................... Date'................................................
i"
Permit to install expires 60 days after issue date
Stove ......................................................................................................................................:......................................................................................................................................................................
StoveClearance ...!.'�...................................................................................................................................................................................................................................................................
Floor .....!"..................................................................................................................................................................................................................................................................................:..............
SmokePipe ...!n:' ...............................................................................................................................................................................................................................................................................
Smoke'Pipe Clearance .° ..................................................................................:...........................:...:...........................................................................................................................
Chimney .........................................................................................................................................................:..........................................................................................................................................
SmokeDetector ....%I C...................................................................................................1..............................................................................................................................................................
The undersigned hereby certifies that the installation of wood burning stove and equipment made under author-
ity of permit dated .................. .: ..:.. ........... has been made in accordance with provisions of the Commonwealth
1
of Massachusetts State Building Code now currently in effect and pertaining thereto �.
Installer
INSTALLATIONAPPROVED ...................................................... By:...............f........................:......................................... Title. ................................. ..................:
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR-- PINK: APPLICANT